Thyroid UK
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Latest Bloods Before Endo

Hello everyone,

I had emergency blood test at GP's last week at had prolonged episode of racing heart. I was diagnosed with prolapsedheart valve and ventricular tachycardia not long before I was diagnosed with Hashimotos (21 years ago). GP thought I might be hyper so took bloods. I have been of reduced dose of Levo (50mcg) and 10mcg of liothyronine for a few months now, after seeing NHS Endo.

Free T3 4.4 pmol/L (3.1-6.8)

Free T4 9.2 pmol/L (12.0-22.0) Low

TSH 2.3 mu/L (0.27-4.20)

I guess I need to up Levo? Got next appointment with Endo on 18th Nov. The liothyronine was a three month trial. Still feeling rubbish, totally fatigued, but very anxious and panicky.

3 Replies

I think you could do with a rise in levo and lio (T4 and T3). Your TSH is too high, your FT3 should be towards the upper end not the low end and your 50mcg levo appears to be too low to convert to sufficientT3.

The latest advice is a therapeutic quivalence was 3:1. ie T4/T3 of whatever dose of levo your on. Maybe give your Endo a copy for information. Excerpt from page 80 on the following link:

"Dose Selection in T3/T4 Study RCTs.The second logical basis for a conclusion

is the actions taken, i.e., the doses given to the subjects. Most subjects received T3 below its adult starting dose of 25 mcg/day.

The subjects in RCTs received T3 in some ratio to the withdrawn T4. The various RCTs used T4:T3 ratios of 14:1, 10:1, and 5:1. Subsequent research by the US National Institutes of Health (NIH) found the therapeutic equivalence was 3:1.

Thus, most of the subjects were under-treated with the T3/T4 combination. In light of the NIH finding, the conclusion that T3 therapy is never needed is invalid"


Thank you Shaws. I certainly will pass on the info to Endo. Without having bloods taken every two minutes I do find it hard to work out if I'm over or under medicated. I seem to get racing heart, fatigue and anxiety for both. GP thought I was hyper when she took those bloods. No feedback from Gp as to actioning results, as per usual.


When you discuss with your Endo, be diplomatic as they are doing as they've been trained. It's just that it doesn't suit some of us and we need a slightly different method.


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